Akron General Employee Health Plan – The Plan 

The following information primarily addresses health plan provisions for the Akron General Employee Health Plan.   Current employees have the opportunity each year to re-enroll for coverage through the Open Enrollment process. Through this process, you can choose to keep the same coverage you have or make changes to it for the upcoming calendar year.
 

Two Tiers of Providers

EHP offers a two-tier network of providers.  As an Akron General EHP member, you can use either provider tier at any time throughout the benefit year and may see providers in both tiers if you choose. The tier you select, however, determines the amount of coverage you will receive. To receive maximum coverage, you must use Tier 1 Providers.

Click here for information on Tier 1 and Tier 2 providers
 
Tier 1 providers consist of the Cleveland Clinic Quality Alliance (QA) network.  The QA is comprised of Cleveland Clinic and regional hospitals, including participating physicians credentialed by the Cleveland Clinic Community Physician Partnership (CPP).   The Tier 1 Network of Providers includes Primary Care Providers (PCP), Specialist Providers (SP), Behavioral Health Providers, and Ancillary Services Providers. Ancillary Services are services such as dialysis, ambulance transportation, durable medical equipment (DME), home health, skilled nursing facilities, hospice and others.
 
Tier 2 consists of two provider networks: All Emergency/Urgent Care services are covered at 100% after co-payment ($50 Urgent Care and $150 Emergency),
 

Third-Party Administrator (TPA)

 EHP members should go directly to the third-party administrator (TPA) to resolve any claims payment issues.
  • The Cleveland Clinic EHP  TPA  is Mutual Health Services (MHS).  The MHS customer service department can be reached by calling 1-800-451-7929.